| Organization Name: | SHELLEY WATERS |
| NPI Number: | 1396913794 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHELLEY WATERS (OWNER/CEO/SLP) |
| Mailing Address: | 2932 Birdsong Cir Grimesland |
| State: | NC US |
| Postal Code: | 278379525 |
| Phone Number: | 2527177924 |
| Fax Number: | 2527570663 |
| NPI Enumeration Date: | 02/19/2008 |
| NPI Last Update Date: | 02/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 6730 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |